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Governments are increasingly concerned to compare the quality and effectiveness of healthcare interventions but find this a complex matter. Crude hospital statistics can be dangerously misleading and need adjusting for case mix, but identifying and weighting the patient characteristics which affect prognosis are problematical for conceptual, methodological, and practical reasons. These include the inherently uncertain nature of prognosis itself and the practical difficulties of collecting and quantifying data on the outcomes of interest for specific healthcare interventions and known risk factors such as severity.

The German healthcare system is one of the most efficient in the world, with enormous potential for patients and society as a whole. Unfortunately, we are far from (yet) utilising this potential. We spend a lot on our health - but we are not healthier: according to the OECD ranking (1), our healthcare expenditure is the second highest in relation to gross domestic product, just behind the USA. In terms of life expectancy, mortality and self-assessment of health status, however, Germany is mediocre at best. Can we, or rather, do we want to continue to afford this? In view of the recurring discussion about the sustainable financing of statutory health insurance funds and the social and economic impact of illnesses, the question seems rhetorical in nature. The goal must be a healthcare system that guarantees the best possible individual care for all people in this system and that can be financed sustainably. This joint position paper is intended as a basis for discussion. It describes the concept and the added value of value- and outcome-orientated healthcare in the sense of Value Based Healthcare (VBHC) for people, the system and society and identifies areas of action in which political support is particularly necessary.

Mental Health Outcome Evaluation bridges the gap between traditional research and evaluation methods by presenting an alternative to the highly technical and statistical methods developed in the laboratory for mental health care professionals. It focuses on outcome evaluation of mental health services for adults, concentrating on the general principles that can be used to assess the service effectiveness of community health centers, clinics, and private practices. The book presents a formidable argument for descriptive outcome studies through its evaluation of the results and consequences of care and treatment as well as clinician ratings. It is written in a non-technical style, making it accessible to anyone in the mental health industry. Key Features * Addresses industry efforts to monitor and assess information about results and consequences of mental health care and treatment * Evaluates use of clinician ratings as outcome information * Offers accessible general principles for managers and mental health services researchers * Presents the best argument for descriptive outcome studies

Most wars do not expand beyond the initial two participants. Why is this so? We argue that wars remain small because initiators select as targets states that they believe will not receive third-party help and that they can defeat without such help. Drawing on the idea of selection effect, a model of this choice is presented and a hypothesis is derived in which initiators (1) will win most often in wars of one against one and (2) will win least often when the target receives any help. This hypothesis is tested against war outcomes for initiators and targets in the period 1816-1975 using probit regression. The expectation is supported. The authors conclude that initiators act as predators and are likely to attack target states they know they can defeat if these targets are not joined by coalition partners. This selection pattern tends to make small wars likely.

As we enter the twenty-first century, the outcomes, consequences, and results of teacher education have become critical topics in nearly all of the state and national policy debates about teacher preparation and licensure as well as in the development of many of the privately and publicly funded research agendas related to teacher and student learning. In this article, I argue that teacher education reform over the last fifty years has been driven by a series of questions about policy and practice. The question that is currently driving reform and policy in teacher education is what I refer to as "the outcomes question." This question asks how we should conceptualize and define the outcomes of teacher education for teacher learning, professional practice, and student learning, as well as how, by whom, and for what purposes these outcomes should be documented, demonstrated, and/or measured. In this article, I suggest that the outcomes question in teacher education is being conceptualized and constructed in quite different ways depending on the policy, research, and practice contexts in which the question is posed as well as on the political and professional motives of the posers. The article begins with an overview of the policy context, including those reforms and initiatives that have most influenced how outcomes are currently being constructed, debated, and enacted in teacher education. Then I identify and analyze three major "takes" on the outcomes question in teacher education—outcomes as the long-term or general impacts of teacher education, outcomes as teacher candidates' scores on high stakes teacher tests, and outcomes as the professional performances of teacher candidates, particularly their demonstrated ability to influence student learning. For each of these approaches to outcomes, I examine underlying assumptions about teaching and schooling, the evidence and criteria used for evaluation, units of analysis, and consequences for the profession. I point out that how we construct outcomes in teacher education (including how we make the case that some outcomes matter more than others) legitimizes but also undermines particular points of view about the purposes of schooling, the nature of teaching and learning, and the role of teacher education in educational reform. In the second half of the article, I offer critique across the three constructions of outcomes, exploring the possibilities as well as the pitfalls involved in the outcomes debate. In this section, I focus on the tensions between professional consensus and critique, problems with the inputs-outputs metaphor, the need to get social justice onto the outcomes agenda, problems with the characterization of teachers as either saviors or culprits, and the connection of outcomes to educational reform strategies that are either democratic or market-driven.